Stuck between their automated systems, beyond frustrated - a rant
By TheRealDawn
@dawnald (85137)
Shingle Springs, California
January 27, 2010 12:19am CST
This one could go under health care or parenting, but the way I'm feeling right now, it's a rant.
Yesterday my daughter got diagnosed with a pre-ulcerous stomach inflammation. It had been causing her some misery for days before we got in to see the doctor and she was missing school. I had guessed that was what it might be, the doctor confirmed it and it looked like we were on our way to getting her well again.
That's when the fun started.
The doctor faxed a prescription to our pharmacy. She told us that this was the best medicine for the condition and, if the insurance didn't cover it, I should have the pharmacy call her for alternatives. So I got to the pharmacy, and, huge shock, the insurance didn't cover it. So I told the pharmacy what the doctor had told me.
The pharmacy called the doctor and could not get through their phone system, so they told me they were faxing something back to the doctor and that we'd probably have something back the next day.
Say what? I have a daughter who is queasy from something that could turn into an ulcer and she has to wait a day? I told the pharmacy it couldn't wait a day and they promised to call my cell if they hear anything.
Well. Knowing how big pharmacies operate (how I wish I had a small one nearby like I did down south), I picked up the over the counter version of the medication and took it home. I was very busy at work that day and by the time I got back to the pharmacy, there was no way to get hold of the doctor. Nothing had happened, of course.
Next day I tried to take my daughter to school and she got sick. The OTC stuff wasn't working yet and I didn't have the prescription stuff. So I took her home, cleaned her up and called the pharmacy. Not open yet. Big sigh. So I went to work.
When I got hold of the pharmacy, huge surprise. Nothing had changed. So at that point I called the doctor's office and told them that somebody needed to call the pharmacy and get her prescription taken care of.
A couple of hours later, I call the pharmacy. Nope, they haven't heard anything and they told me that the prescription was $160 without insurance. Keeping that in mind as a last resort option, I called the doctor's office back. And couldn't get through.
Now, I do not consider myself a nervous, worry wart mother, not at all. But at this point I was pretty frustrated at the fact that my daughter was sick and unable to go to school and there didn't seem to be much I could do about it except either wait or nag the heck out of somebody until it got taken care of.
A while later I called the doctor's office back again. This time I got somebody I knew who happened to remember that I had been really patient with their new computer system last week. Hooray, somebody I have brownie points with. So she took the information and said she'd get an urgent message through to the doctor.
At this point, I had to go to an appointment, so I couldn't try the pharmacy again until it was after business hours again. Well this time they had talked to the doctor and the doctor had told them to try the generic version of the medicine. Nope, it hadn't gone through either. The doctor had told them she was going to call the insurance company.
Well, it's after business hours, right? So how many of you want to bet that the doctor had the insurance company on the phone right then and there and got it taken care of that night? Ha! Most likely she's going to call them in the morning.
I am now beyond frustrated and we go to the pharmacy. And I am just not good at being firm with people, so I sic the husband on the pharmacist. So he asks her what she can do for us. Well hooray, she gives us the "in house" discount, which is $100 off the price they originally told us.
So tomorrow the husband is going to forget to call the insurance company and complain. Well heck, I work for the idiots. Maybe I'll just pull the CEO's phone number off of the employee phone list and drop him a message. I've been thinking of staying home with the kids anyway. 
Seriously folks, if we had waited until tomorrow when the doc called the insurance, I have no doubt they would have made an exception and they would have authorized the pills. And meanwhile, a 13 year old girl on her way to having an ulcer would have missed another day or two of school after sitting home feeling miserable.
As it is, I feel like I waited a day too long to get pushy with the doctor's office and the pharmacy.
But this, I guess, is where I end the rant and thank my lucky stars that I live in a place where this medication is available and I only had to wait a few days and ultimately I could do something about it. Because I know that the frustration I was feeling is just a fraction of what some parents go through in other parts of the world. And doing something about that? Now that's powerlessness and frustration!
Seriously folks, if we had waited until tomorrow when the doc called the insurance, I have no doubt they would have made an exception and they would have authorized the pills. And meanwhile, a 13 year old girl on her way to having an ulcer would have missed another day or two of school after sitting home feeling miserable.
As it is, I feel like I waited a day too long to get pushy with the doctor's office and the pharmacy.
But this, I guess, is where I end the rant and thank my lucky stars that I live in a place where this medication is available and I only had to wait a few days and ultimately I could do something about it. Because I know that the frustration I was feeling is just a fraction of what some parents go through in other parts of the world. And doing something about that? Now that's powerlessness and frustration!7 people like this
17 responses
@p1kef1sh (45681)
•
27 Jan 10
I never cease to be amazed by the US health system Dawn. In my small city of 63,000 including a rural area that spreads up to six miles there are at least five pharmacies. If one doesn't have it the next will. But in any case our doctor will get it for you if you cannot. Two of our pharmacies deliver to your home free of charge. The total cost (per item - 1 packet of pills or 100 packets of the same medicine is the same charge) is £7.20 (about $10) but in your daughter's case, as she is under 16 it would have been free. American opponents of the British National Health Service point to it's failings. But no entitled citizen ever goes without care because of poverty. I just paid for my own daughter to visit her doctor in the US. She has a lump on her neck. For $35 the doctor confirmed that yes, it is indeed a lump! LOL. In fairness she did take blood and confirmed a lymphatic infection too. But here all that diagnosis would have been free. I hope that your daughter feels better soon.
2 people like this
@tamarafireheart (15384)
•
27 Jan 10
Hi dawnald,
I am so sorry that you had to go through all this and your poor daughter too suffering, but why did it take a man for the pharmacy to take action?, if that happened to me I would take my daughter to the doctors or the pharmacy and stay there till they sort things out, this is so outrages, I would have been so furious, glad it has been sorted in the ed.
Tamara
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
Honestly I was just sick of dealing with it, so I sent him over. He's the one who asked them "what can you do for me".
@cloudwatcher (6861)
• Australia
27 Jan 10
You have every right to rant!
Firstly, I sure hope Dearra is feeling lots better by now and benefitting from the medication. How frustrating for both of you.
I am 99.9% sure that the same thing would not happen here. Until recently I had only been to the doctor once in the last 19 years, so I'm no expert, but my husband is a regular patient. He has run out of medicines a few times and he has only had to wait a few minutes for a repeat prescription to be written out. We've never had any hassles with the health system.
2 people like this
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
She's halfway better, but still no school today. She was able to eat about 1/3 of a bagel.
@scarlet_woman (23463)
• United States
28 Jan 10
ooh..been there.
had an ulcer they suspected was preferating..and the insurance company originally said no because appearently "stress related illnesses are self induced"..
considering what i was paying for the insurance to say i went ape**it was an understatement.
1 person likes this
@scarlet_woman (23463)
• United States
29 Jan 10
yup.it certainly didn't help things.
1 person likes this
@sid556 (30953)
• United States
27 Jan 10
Hi Dawn,
Well I hope today goes much better and I'm sure it will now that your daughter has the meds that she needs. I had a similar experience when trying to get my daughter her inhaler a while back. Still, it was not as serious as your daughter's situation but the run a round you get from all 3 of these places is outrageous. I don't understand why the insurance companies have the right to turn down something a doctor prescribes to begin with. They don't know what's best for the patient.
1 person likes this
@zed_k4 (17589)
• Singapore
28 Jan 10
So, do you still have to pay the remaining $60 or the insurance can cover that? I would be downright angry, worried and frustrated as well. Imagine your daughter having to wait and you having to run here and there, with not much solution in place. I hate waiting, in that kind of circumstance. It would make me pounce like a tiger, for I dislike restlessness in that form, especially when it involves my love one. So on a happier note, I'm glad that the medicine works out to be fine and hope your daughter recovers soon enough.
1 person likes this
@gabs8513 (48686)
• United Kingdom
28 Jan 10
Wow Dawn I have to say that is just awful, I mean how can they justify this I do not understand it
Here in the UK Children under 16 do not pay for any Medication at all, then People just pay for prescriptions which is a set Price for everyone there is no messing about like that specially not with Children
I hope the little one is feeling better now and I hope after all that the Medicine is working
@dawnald (85137)
• Shingle Springs, California
28 Jan 10
I had to call their 'advice line' today because she still isn't feeling all that much better. They told me that it was too soon to worry, it could take up to 2 weeks. Wonderful (not), but at least now I know...
I thought it was mainly middle aged self employed me who developed ulcers.
@dawnald (85137)
• Shingle Springs, California
4 Feb 10
We are wondering the same thing. Maybe it was the stress with the algebra homework the week before...
@BarBaraPrz (51819)
• St. Catharines, Ontario
27 Jan 10
If that kept up, you yourself could be on your way to an ulcer. Glad it turned out ok in the end.
Now, you have to find out what's bothering your daughter so much and how it can be taken care of. The meds will take care of the symptoms but won't do anything for the cause.
Good luck.
1 person likes this
@Hatley (163772)
• Garden Grove, California
28 Jan 10
hi dawnald I can and do sympathize because once I had severe bronchitis and unfortunately my own doctor was down with the
same thing. well his stand in doctor was not nearly as great. He prescribed an antibiotic that was not on the approved meds for my insurance so I would have to pay an outrageous amount which I just barely had. so I get to the pharmacy and they do call the doctor,his remark well if she really wants to get well she must get this, she shouldnt cut back on meds just because its more than she expected but yes you can give her the generic,.so then they tell me all this but say they are out of the generic, have to order it and wont have it for two days. Here I am standing there coughing, my voice barely adequate, so since I have the amount for the prescribed medication with me I am forced to pay it. now I had the med but would have to live on beans for the rest of the week. ugh.that pharmacist should have to live with severe bronchitis for a week with no meds, and see how he liked it. I will never forget that morning, andhow furious I was with both the stand in doctor and that really nasty pharmacist. I was glad when he quit to work somewhere else. Seems to me like the doctors and the pharmacies could work together to get us our meds in a timely way instead of making us wait and wait and wait. Also some doctors need some lessons in chairside manners. He knew darned well I lived on a small social security
check so he had had no right in putting me down for not wanting to spend so much money. I had about a dollar left for a whole week after buying that prescription. I told my real doctor about it and he said,you should have called my answering service. oh yeah right as if I would have been able to get hold of him.
check so he had had no right in putting me down for not wanting to spend so much money. I had about a dollar left for a whole week after buying that prescription. I told my real doctor about it and he said,you should have called my answering service. oh yeah right as if I would have been able to get hold of him.
1 person likes this
@dawnald (85137)
• Shingle Springs, California
28 Jan 10
Maddening, and you can stay on the phone for what seems forever and get nowhere...
@bunnybon7 (50970)
• Holiday, Florida
31 Jan 10
i know what you mean. i go through that crap every time i have to renew prescription which is what makes me so irrated with it. Since you are like me and cant get pushy with these people you should probably put hubby on it as soon as you see its going to be any problem. i have done this with son because one time i was going through a problem getting my inhaler renewed and stupidly forgot untill i needed it that day. my son got on the phone and told the nurse at doctors office that the doctor had better call in that script or if anything happened to his mom he'd have the docs liscense
of cours the pharmacy called 2 hrs later saying the inhaler was ready to be picked up
of cours the pharmacy called 2 hrs later saying the inhaler was ready to be picked up@dawnald (85137)
• Shingle Springs, California
1 Feb 10
He tends to fail to follow through though. He still hasn't called the insurance to complain...
@paula27661 (15811)
• Australia
30 Jan 10
These types of situations are so frustrating! I have a lot of trouble taking a firm stance with people and I used to say nothing instead of asserting myself from the beginning until the situation would get unbearable and I would then proceed to lose it and become angry and handle the whole thing way too aggressively. I’m glad you sorted it out in the end; it is maddening when you are asked to wait and then nothing is done! I hope your daughter is much better now...
1 person likes this
@thea09 (18305)
• Greece
27 Jan 10
What a complete fuss when right at the start the dr said the insurance might not cover it. Over here if we need a prescription I get the dr to look it up in the book to see if its expensive or not and if it is to see if there's a cheaper version. It all sounds very inaccessible and complicated over your way. Hope your daughter is feeling better.
1 person likes this
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
She says she's halfway better...
Yep what a complete fuss. And I bet the doctor didn't even have a clue what a mess their phone system was either!
@msfrancisco9369 (10002)
• Boston, Massachusetts
27 Jan 10
Hi Dawn,
I can empathize with you for what you've been through. it's really frustrating that you can't do anything while your kid needs it badly. there's a lot of things that need to be looked into the system. your country is more advanced than us but still you experience all this complexities and delays.
How's your daughter? i hope she's responding positively to the medicines. please give my hugs to her friend!
1 person likes this
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
She feels halfway better but she's still not eating a full breakfast and she wasn't 100% this morning. Hopefully tomorrow...
@Thoroughrob (11742)
• United States
27 Jan 10
I know just how you feel. After my sons surgery, getting his meds was a nightmare. I had to refill once a month and I dreaded the day. It would usually take me 2 days to get them in hand. My son had insurance and medicaid. If the insurance would ok it, then medicaid would deny. Insurance wanted it all in 90 day supply, but medicaid would not approve over 30. I was a nervous wreck every time it was time to refill, because without the meds, he would start a withdrawl, which would be just like a junkie trying to get clean. If I paid for the 90 day supply, it was $50 for each prescription, and he has 4. My other son, is not on medicaid because he is not disabled and we already pay for 3 for him. It was just horrible. I hope that you have gotten your meds and are able to calm down. The medical field can drive you crazy.
1 person likes this
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
We got them, but we had to pay 'retail'. Discounted retail, but still, it was aggravating.
@ANTIQUELADY (36440)
• United States
27 Jan 10
U have a right to rant, that is absolutely ridiculous that they did u that way. U were alot nicer than i would have been. I would have shown my a$$ for sure w/everybody concerned. Might not have done any good but i would have done it anyway. I never could stand for my kids to be sick & if they wern't getting the care they needed i let everybody know, still would even tho they are grown. If it was my grandson guess i'd try to whip someone over him. I'm sorry u have had such a time. I hope dearra is feeling all better. They all need a good jerking up!!!
1 person likes this
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
I should have got on them sooner, but I really didn't think it would take this long to resolve the issue. Far as I know, it still isn't resolved.
@purplealabaster (22085)
• United States
27 Jan 10
I think that you were very patient and calm during this whole thing. I would have been bugging the doctor, pharmacy, health insurance and anybody else that I could possibly get to listen to me. If it is for myself, then I will wait until the very last minute to take action and I have a lot of patience. However, when one of my children is really sick, then I want something done as soon as possible not when they get around to doing it, which is usually when the situation gets to the point where hospitalization is required.
I hope that the medicine helps your daughter quickly, and her stomach gets better fast. I know that as a parent it is very hard to watch your children be sick and in pain, and I know that you would take her place in a heartbeat if you could. *HUGS*
I am very lucky to live in the country. My doctor's office knows my whole family, so they are able to take very good care of us without having to go into elaborate explanations every time I call with a question or need to make an appointment or whatever. I know people that have had to wait several days to get seen by a doctor, even though they were really sick, because the doctor's office was a larger one and they were very impersonal and ran it like a business rather than a place to help people. I can't imagine what these people would have to do if they had a problem with their prescription, when they have to wait days just to get an appointment in the first place.
Our pharmacy also knows us by name. They are really helpful and have not only made calls to the doctor but also to the insurance company on our behalf. They will make exceptions to the rules if we really need the medicine, too. One time I was in a great deal of pain and the doctor had prescribed Lortab for me. The pharmacy did not have enough to fill the prescription, because the shipment had been delayed due to a bad storm. They are not supposed to partially fill the order, but they made an exception because they knew that I really needed the medicine and it was not my fault that their shipment had been delayed. I guess that I have taken them for granted, but after reading about the troubles with your pharmacy, I think that I will take the time to thank the people in the one that I use for doing such a great job and going the extra mile to help us.
I hope that the medicine helps your daughter quickly, and her stomach gets better fast. I know that as a parent it is very hard to watch your children be sick and in pain, and I know that you would take her place in a heartbeat if you could. *HUGS*
I am very lucky to live in the country. My doctor's office knows my whole family, so they are able to take very good care of us without having to go into elaborate explanations every time I call with a question or need to make an appointment or whatever. I know people that have had to wait several days to get seen by a doctor, even though they were really sick, because the doctor's office was a larger one and they were very impersonal and ran it like a business rather than a place to help people. I can't imagine what these people would have to do if they had a problem with their prescription, when they have to wait days just to get an appointment in the first place.
Our pharmacy also knows us by name. They are really helpful and have not only made calls to the doctor but also to the insurance company on our behalf. They will make exceptions to the rules if we really need the medicine, too. One time I was in a great deal of pain and the doctor had prescribed Lortab for me. The pharmacy did not have enough to fill the prescription, because the shipment had been delayed due to a bad storm. They are not supposed to partially fill the order, but they made an exception because they knew that I really needed the medicine and it was not my fault that their shipment had been delayed. I guess that I have taken them for granted, but after reading about the troubles with your pharmacy, I think that I will take the time to thank the people in the one that I use for doing such a great job and going the extra mile to help us.1 person likes this
@dawnald (85137)
• Shingle Springs, California
27 Jan 10
I should have started bugging them sooner, but I was hoping that the OTC stuff would tide her over until it was resolved. Half a day OK, but a day and a half? Nope, not acceptable!
